Summary & Overview
CPT 00192: Anesthesia for Radical Facial Bones or Skull Surgery
CPT code 00192 designates anesthesia services for radical surgical procedures on the facial bones or skull, including management of operative cases such as prognathism repair. This code is used to document the anesthetic care required for complex craniofacial and maxillofacial surgeries that often require advanced airway management and intraoperative physiologic monitoring. Nationally, accurate use of this code matters for clinical documentation, appropriate payment for high-acuity anesthesia services, and aggregation of utilization data for surgical specialties.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise briefing on clinical context and service setting, a summary of common modifiers and associated provider taxonomies, and references to related anesthesia codes. The publication also outlines ICD-10 diagnostic contexts commonly billed with this service and highlights a closely related code, 00190, for facial bones or skull anesthesia when not otherwise specified.
This summary equips anesthesiology groups, perioperative billing teams, and health plan analysts with the information needed to identify where 00192 applies in practice, what clinical scenarios typically generate the code, and which payers are relevant for prior authorization and claims adjudication workflows. Data not available in the input: detailed national utilization rates and payer-specific reimbursement benchmarks.
Billing Code Overview
CPT code 00192 describes anesthesia services provided for a patient undergoing radical surgical procedures on the facial bones or skull, including procedures to address prognathism (protrusion of the lower jaw). This service involves administration and management of anesthesia tailored to complex craniofacial or maxillofacial operations.
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Service type: Anesthesia for radical facial bones or skull surgery
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Typical site of service: Operating room or surgical suite in an acute care hospital or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents with symptomatic prognathism requiring radical corrective osteotomy of the mandible and adjacently involved facial bones. The surgical plan includes segmental osteotomies of the lower jaw, possible fixation with plates and screws, and reconstruction of contiguous facial bone segments under general anesthesia. The anesthesia team performs a preoperative evaluation, documents airway assessment (Mallampati, mouth opening, neck mobility), reviews comorbidities and medications, obtains informed consent for anesthesia risks, and selects an anesthetic plan that may include general endotracheal anesthesia with muscle relaxation and invasive monitoring if indicated.
Perioperative workflow: the anesthesiology or CRNA team manages preoperative optimization in the holding area, establishes intravenous access, administers induction agents, secures the airway (which may require fiberoptic or awake techniques for complex facial anatomy), maintains anesthesia throughout radical facial/skull surgery, provides intraoperative hemodynamic and blood-loss management, coordinates local/regional blocks if used, and manages emergence and immediate postoperative airway and pain control in the PACU or ICU as indicated. Typical sites of service are the main operating room or a dedicated surgical suite equipped for major craniofacial procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia complexity or surgical exposure requires substantially greater work than usual, documented in anesthesia record. |